Clostridium difficile 

Introduction 

C difficile

The symptoms of C difficile range from mild to very severe diarrhoea. Get expert advice on how to avoid it, how it spreads and treatments that can control the disease.

Media last reviewed: 14/05/2013

Next review due: 14/05/2015

Antibiotics

Antibiotics are medications that are used to treat, and in some cases prevent, bacterial infections

A Clostridium difficile infection is a type of bacterial infection that can affect the digestive system. It most commonly affects people who have been treated with antibiotics.

The symptoms of a C. difficile infection can range from mild to severe and include:

  • diarrhoea  
  • a high temperature (fever) of above 38ºC (100.4ºF)
  • painful abdominal cramps

A C. difficile infection can also lead to life-threatening complications such as severe swelling of the bowel from a build-up of gas (toxic megacolon).

Read more about the symptoms of Clostridium difficile and complications of a Clostridium difficile infection.

Causes

Spores of the C. difficile bacteria can be passed out of the human body in faeces (stools) and can survive for many weeks, and sometimes months, on objects and surfaces.

If you touch a contaminated object or surface and then touch your nose or mouth, you can ingest the bacteria.

The C. difficile bacteria do not usually cause any problems in healthy people. However, some antibiotics can interfere with the natural balance of normal bacteria in the gut that protects against C. difficile infection.

When this happens, C. difficile bacteria can multiply and produce toxins (poisons) that cause symptoms such as diarrhoea.

Read more about the causes of a Clostridium difficile infection.

Treatment

A mild C. difficile infection can usually be controlled by withdrawing treatment with the antibiotics causing the infection.

More severe cases can be treated using the following antibiotics:

  • vancomycin
  • metronidazole

The condition usually responds well to treatment, with symptoms improving in two to three days and clearing up completely within 7 to 10 days.

However, relapse is common, occurring in around one in four cases, and requires further treatment. Some people have two or more relapses.

Life-threatening cases may need surgery to remove a damaged section of the bowel. This is needed in less than 1% of cases.

Severe cases of C. difficile infection can be fatal, especially when they occur in people who are already very ill.

Read more about treating a Clostridium difficile infection.

Prevention

C. difficile bacteria spread very easily. Despite this, C. difficile infections can usually be prevented by practising good hygiene in healthcare environments, such as washing hands regularly and cleaning surfaces using products containing bleach.

If you are visiting someone in hospital with C. difficile, you can reduce the risk of spreading infection by washing your hands before and after entering the bed space. Alcohol hand gel is not effective against C. difficile spores, so the use of soap and water is essential.

Read more about preventing a clostridium difficile infection.

Who is affected?

The majority of C. difficile cases occur in people who have had antibiotics. This may be in a healthcare setting, such as a hospital or care home, but can also occur at home without ever going to hospital.

Older people are most at risk from infection, especially those who are frail or with medical conditions. People over the age of 65 account for three-quarters of all cases.

In recent years, the number of C. difficile infections has fallen rapidly. There were 14,687 reported cases in England from April 2012 to March 2013, compared with 52,988 in 2007.

However, a new strain of the C. difficile bacteria called NAP1/027 has emerged in recent years. This new strain tends to cause more severe infection.

There has also been an increase in the number of C. difficile infections occurring outside a healthcare setting (known as community-acquired Clostridium difficile infection).

Page last reviewed: 22/04/2014

Next review due: 22/04/2016

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The 1 comments posted are personal views. Any information they give has not been checked and may not be accurate.

millergirl said on 24 September 2014

I have returned from a 2 week holiday in Turkey and been diagnosed with Clostridium Difficile. I started with stomach pains and then diarrhoea on the 7th day of my holiday. We had to get a prescription from the pharmacy which consisted of 10 tablets and a box of drink satchets.. I had not been on anti biotics and other people were having the same symptoms. As there were a majority of people from other countries who did keep to themselves I dont know if they had problems too. I have n ot b een given any treatment but told by nurse at surgery that the disease will have to be 'flushed' out of my system naturally. As I have grandchildren and great grandchildren visiting very often I asked if I was infectious to them and was told no but on checking with NHS on 111 was told I was infectious and to keep away from the family. I am still having the bowel problems and wonder just how long this will last. Is there any one who has contracted this from a holiday hotel that can give me any information I would be grateful for any help..

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